hoarding disorder
understanding, supporting, and managing through community involvement
understanding, supporting, and managing through community involvement
Amber Harrison
York Community Services Association
This presentation explores hoarding disorder, focusing on understanding its psychological roots and the unique challenges faced by older adults. In this video, we’ll define hoarding, examine its prevalence among older adults, and consider why it’s critical to approach this issue with empathy. Real-life examples illustrate the emotional attachment and fear of scarcity that drive hoarding behaviors.
The video ends with actionable reflectison and resources to explore hoarding disorder further.
Reflection: Hoarding Disorder, Part 1
"What do your possessions say about you?"
Consider how your personal items reflect your identity, values, and experiences. Do you keep things because they serve a purpose, or because they hold sentimental value?
"Are your items creating memories or weighing you down?"
Ask yourself whether certain possessions bring joy and connection to the past, or if they’ve simply become burdens you’re struggling to manage.
“What would a balanced, clutter-free environment mean for you personally?”
Consider how you could take one small step toward creating that space.
Click here to complete the first of three reflections in this chapter. Entering your reflection will also record your progress. Important: Complete each section before moving on to its corresponding reflection. When you return to the form, you will automatically be taken to where you last left off.
Activity--Starting a Conversation
Before you move to the second part of the hoarding disorder training, let's start a conversation. Click on the plus button in the Padlet below to explore common values and beliefs that may influence hoarding behaviors and affect willingness to seek help. There are no 'wrong' answers here - this exercise aims to provide insight into the thought processes of someone living with hoarding disorder.
Note: if the Padlet does not work here, click here to visit and contribute.
Hoarding Disorder, Part 2
The second video shifts focus to treatment, emphasizing community-based approaches involving public health, social services, family, and friends.
While there is no single cure for hoarding, collaborative support offers the most effective path to progress.
We’ll discuss how community partners can provide essential resources and introduce the potential role of AI in future treatment support. This video concludes with actionable reflections and curated resources, offering viewers practical insights and ongoing support options.
Reflection: How Hoarding Affects Others and Our Community
"How might hoarding affect the community around you—your neighbors, family, and friends?“
Think about aspects like:
The physical safety or clutter issues in shared spaces (e.g., hallways, communal areas).
Emotional effects, such as isolation or strained relationships.
How it might impact neighbors or others who may be concerned for the individual.
Click here to complete the second of three reflections in this chapter. Entering your reflection will also record your progress. Important: Complete each section before moving on to its corresponding reflection. When you return to the form, you will automatically be taken to where you last left off.
Hoarding Disorder--A Review and Case Scenario
Review: Click on the flip cards to review a few key points about hoarding disorder.
Source - Association for Behavioral and Cognitive Therapy (nd). Hoarding Fact Sheet
Case Study
Now that we've reviewed some of the key learnings about hoarding disorder, click through the case study below (based on The Hoarder's Widow by Allie Cresswell). As you are reading about this case study, consider the following:
What factors do you think influenced Clifford's hoarding behavior?
What factors influenced Maisie to accept help?
Use the arrows to click to the next slide.
Reflection: Hoarding and the Role of Age-Friendly Communities
"What are some ways that your Age-Friendly community can raise awareness of hoarding disorder and support people who are living with it?“
Think about aspects like:
How is your local health officer addressing the issue? Can age-friendly support what they are doing?
What resources are available to provide education about hoarding disorder?
Which organizations are available to support someone living with hoarding disorder?
Click here to complete the third of three reflections in this chapter. Entering your reflection will also record your progress. When you have completed the final reflection, please submit.
Additional Resources
American Psychological Association (APA): Hoarding Disorder
The APA offers articles, research, and resources on hoarding disorder, including its relationship to mental health conditions like OCD and anxiety.
Children of Hoarders (COH)
This site provides support specifically for individuals with family members affected by hoarding, including resources on coping and organizing.
The Consequences of Clutter Report:
Senator Bob Casey released a new report from the Senate Aging Committee highlighting the impact of hoarding disorder on older Americans, first responders, and communities, revealing that it affects up to 14 million Americans, especially older adults.
The Gerontological Society of America (GSA): Hoarding Disorder
GSA provides research and articles specifically related to hoarding disorder in older adults, offering insights on its impact on aging and mental health.
Hoarding: Buried Alive (Documentary)
A TV series that follows individuals dealing with severe hoarding. It offers a look into the emotional and psychological aspects of hoarding and how it affects families and lives.
Hoarding: For Mental Health Professionals: International OCD Foundation
Hoarding & Squalor: A Guide to Treatment
A comprehensive guide for professionals, offering information on the treatment of hoarding disorder, including therapeutic approaches, resources for clinicians, and case studies.
The International OCD Foundation (IOCDF): Hoarding Disorder
Provides information on the link between hoarding disorder and obsessive-compulsive disorder (OCD), treatment resources, and support for individuals with hoarding tendencies.
Hoarding Disorder Overview: Mayo Clinic’s resource covers hoarding symptoms, risk factors, complications, and possible treatments.
National Alliance on Mental Illness (NAMI)
NAMI offers resources for mental health conditions, including hoarding disorder, with guides on managing symptoms and support options.
National Institute of Mental Health (NIMH): Hoarding Disorder
NIMH provides detailed information on hoarding disorder, including its symptoms, causes, and treatment options. It's a great starting point for understanding the basics of hoarding.
Sensory Cognitive Behavioral Therapy (CBT)
A recent study explores using sensory CBT, particularly imagery rescripting, to help individuals with hoarding tendencies. This method helps patients visualize positive outcomes from discarding items, showing promise for reducing anxiety and improving their willingness to part with possessions.
Article - Community Program to Support People Living with Hoarding Disorder
Noyes, S., van Houten, S., Wilkins, E. (2024). A 'Friendly Visitor' Volunteer Intervention for Hoarding Disorder. Participant's Perceptions. The Open Journal of Occupational Therapy, Vol 12, (2).
Books on Hoarding:
Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding by David F. Tolin, Randy O. Frost, and Gail Steketee
The Hoarding Handbook: A Guide for Human Service Professionals by Robin Zasio
The Oxford Handbook of Hoarding and Acquiring: Frost, R.O., & Steketee, G. (Eds.), Oxford University Press, 2014
Fiction Depicting Hoarding Disorder
The Hoarder's Widow. by Allie Cresswell. This book is the basis of our case study (above). The author moves between Maisie's story and Clifford's, allowing us to see into the mind of someone living with hoarding disorder and their loved ones.
Meet Your Chapter Guide - Amber Harrison
Amber Harrison
Amber joined York Community Services Association in January of 2023 as the Housing Innovation Manager. She has worked for the last decade for the Town of York as the Director of Code Enforcement and Local Health Officer. Amber’s varied experience included implementing ordinances on land use and development, as well as collaboration with Town leaders, businesses, and social services to perform Health Officer duties often with those most in need in our community. She looks forward to continuing her Health Officer role for the community while creating and advocating for an increase in affordable housing, age-friendly initiatives, and community service opportunities in Southern Maine.
During this chapter, we hope you will gain a few tools to raise awareness of hoarding disorder.
If you have any questions as you are going through the material, please email: lifelong@maine.edu.
The Lifelong Maine Skill Building Series was developed as part of the Community Connections project.
Funding for the project was provided through support of the Governor's Cabinet on Aging and Office of Aging and Disability Services.
We are deeply grateful for the funding and for the thought leadership provided by Elizabeth Gattien, Coordinator of the Governor's Cabinet on Aging.